-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]] On
Behalf Of Dr L Russell
Sent: 09 June 1998 09:04
To: [log in to unmask]
Subject: RE: MRSA on nappy rash
Andrew,
You miss the point.
Firstly I have no idea of your prescribing practice and my second sentence
was typed with my brain very much in gear but driven at the generic GP who
does still give antibiotics to patients (young or old) with URTIs.
In which case, you should have taken rather more care not to make it look
like it was directed specifically at me
Secondly, I am surprised that you feel that the child not having had
antibiotics is relevant. This is precisely the point. He/she caught it off
someone else with MRSA. Do you postulate spontaneous mutation of a pure
growth in a nappy and with no evolutionary pressure? This is why we (note
the person) have been so ill-advised to give sophisticated antibiotics to
patients with viral URTIs. This month a child with MRSA in his nappy rash.
Next month my child with it in his lungs.
There is considerable interest from our PH department at present, because
this child does not appear to have any contacts for MRSA. They can't find
one.
Don't take this personally. We should all share the blame for your patient
with MRSA pneumonia. But we must stop now or face the microbiological
consequences. We must resist the urge to give out antibiotics not just in
children but in everyone with viral URTI.
Great commercial, and medical advisers like me will love you for it, but you
need to take more care with the way you write e-mail, or you are in for an
exciting time.
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